Patterns of drug and alcohol use associated with lifetime sexual revictimization and current posttraumatic stress disorder among three national samples of adolescent, college, and household-residing women

Abstract

Sexual revictimization (experiencing 2 or more rapes) is prevalent and associated with increased risk for posttraumatic stress disorder (PTSD) and substance use. However, no national epidemiologic studies have established the prevalence or relative odds of a range of types of substance use as a function of sexual victimization history and PTSD status. Using three national female samples, the current study examined associations between sexual revictimization, PTSD, and past-year substance use. Participants were 1763 adolescent girls, 2000 college women, and 3001 household-residing women. Rape history, PTSD, and use of alcohol, marijuana, other illicit drugs, and non-medical prescription drugs were assessed via structured telephone interviews of U.S households and colleges in 2005–2006. Chi-square and logistic regression were used to estimate the prevalence and odds of past-year substance use. Relative to single and non-victims: Revictimized adolescents and household-residing women reported more other illicit and non-medical prescription drug use; revictimized college women reported more other illicit drug use. Past 6-month PTSD was associated with increased odds of drug use for adolescents, non-medical prescription drug use for college women, and all substance use for household-residing women. Revictimization and PTSD were associated with more deviant substance use patterns across samples, which may reflect self-medication with substances. Findings also could be a function of high-risk environment or common underlying mechanisms. Screening and early intervention in pediatric, primary care, and college clinics may prevent subsequent rape, PTSD, and more severe substance use.

Sexual Traumatic Event Exposure, Posttraumatic Stress Symptomatology, and Alcohol Misuse Among Women: A Critical Review of the Empirical Literature

“…There is a well-documented association between sexual assault and alcohol misuse that has been observed across representative population-based samples (McCauley, Ruggiero, Resnick, & Kilpatrick, 2010;Resnick, Walsh, Schumacher, Kilpatrick, & Acierno, 2013;Timko et al, 2008;Zinzow et al, 2012), college samples (Bedard-Gilligan, Kaysen, Desai, & Lee, 2011;Corbin, Bernat, Calhoun, McNair, & Seals, 2001;Larimer, Lydum, Anderson, & Turner, 1999;Littleton, Grills-Taquechel, & Axsom, 2009;Marx, Nichols-Anderson, Messman-Moore, Miranda, & Porter, 2000;McCauley, Ruggiero, Resnick, Conoscenti, & Kilpatrick, 2009;Miranda, Meyerson, Long, Marx, & Simpson, 2002;Nguyen, Kaysen, Dillworth, Brajcich, & Larimer, 2010;Stappenbeck, Hassija, Zimmerman, & Kaysen, 2015;Walsh et al, 2014), and minority samples (Han et al, 2013;Ulibarri, Ulloa, & Salazar, 2015). There is a well-documented association between sexual assault and alcohol misuse that has been observed across representative population-based samples (McCauley, Ruggiero, Resnick, & Kilpatrick, 2010;Resnick, Walsh, Schumacher, Kilpatrick, & Acierno, 2013;Timko et al, 2008;Zinzow et al, 2012), college samples (Bedard-Gilligan, Kaysen, Desai, & Lee, 2011;Corbin, Bernat, Calhoun, McNair, & Seals, 2001;Larimer, Lydum, Anderson, & Turner, 1999;Littleton, Grills-Taquechel, & Axsom, 2009;Marx, Nichols-Anderson, Messman-Moore, Miranda, & Porter, 2000;McCauley, Ruggiero, Resnick, Conoscenti, & Kilpatrick, 2009;Miranda, Meyerson, Long, Marx, & Simpson, 2002;…”

Sexual revictimization, PTSD, and problem drinking in sexual assault survivors

“…Posttraumatic stress disorder (PTSD) and problem drinking are common consequences of adult sexual assault (ASA) (Walsh et al, 2014). Some studies suggest that PTSD and problem drinking comorbidity can be explained by the self-medication model, which proposes that survivors drink to cope with PTSD symptoms (e.g., Cappell & Greeley, 1987).…”

The association between childhood maltreatment, psychopathology, and adult sexual victimization in men and women: results from three independent samples

“…As maladaptive outcomes associated with CM – substance misuse, PTSD, MDD – have also been found to increase the risk of adult sexual victimization, it is not surprising that survivors of CM are at increased risk for revictimization (Classen et al 2005). Furthermore, compared to either CM or adult sexual trauma only, sexual revictimization is associated with substance misuse and multiple psychiatric diagnoses including MDD, PTSD, schizophrenia, and bipolar disorder (Classen et al 2005; Walsh et al 2014) highlighting the importance of considering multiple trauma exposures in the psychiatric setting.…”